Individual
EBENEZER KOFI BENTUM ODOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
21530 HILLSIDE AVE, QUEENS VILLAGE, NY 11427-1831
(718) 740-1701
(718) 740-1901
Mailing address
1010 NORTHERN BLVD STE 328, GREAT NECK, NY 11021-5329
(516) 233-2484
(516) 304-5850
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
230787
NY
Other
Enumeration date
10/03/2006
Last updated
10/23/2024
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